ABSTRACT
OBJECTIVE: Airway management has undergone a dramatic transformation since the arrival of video laryngoscope (VL). VL has higher intubation success rate on first try and lower complications in comparison to direct laryngoscope (DL). The use of VL is recommended in intubating COVID-19 patients to speed up intubation time and reduce failure rate. A team from Airlangga University developed Wycope Video Laryngoscope (Wycope VL), a VL with Wi-Fi connection to smartphones for an easier VL with low cost. This study aimed to compare the effectiveness of Wycope VL, C-MAC Video Laryngoscope (C-MAC VL), and DL. MATERIALS AND METHODS: This study was an analytic observational study with a cross sectional design, involving 63 patients who were divided into 3 groups based on the type of laryngoscope, namely Wycope VL, C-MAC VL, and DL. Intubation is carried out by 4th year anaesthesiology resident. Research subjects were patients who will undergo elective surgery at Dr. Soetomo General Hospital under general anaesthesia using orotracheal tube. Inclusion age of 19-64 years, PS ASA 1-2, no anatomical abnormalities of the airway, did not have difficult airway, and was willing to participate in the study. RESULTS: All patients were successfully intubated without complications. C-MAC VL (5.33±1.42 seconds) and Wycope VL (5.95±0.74 seconds) was significantly faster in seeing vocal folds and glottis compared to DL (7.14±0.72 seconds) with P=0.000. DL was significantly faster in average time of intubation (15.52±5.90 seconds) compared to C-MAC VL (16.95±1.11 seconds) and Wycope VL (20.29±2.81 seconds) with P=0.000. CONCLUSION: DL was faster compared to VL in speed of intubation while C-MAC VL and Wycope VL was faster in viewing the vocal folds and glottis compared to DL.
Subject(s)
COVID-19 , Laryngoscopes , Humans , Young Adult , Adult , Middle Aged , Cross-Sectional Studies , Intubation, Intratracheal , LaryngoscopyABSTRACT
As a global burden, the coronavirus disease 2019 (COVID-19) pandemic is going on spread. It has many clinical manifestations and impacts on humans worldwide. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection causes systemic illness through its known receptor binding to angiotensin-converting enzyme 2 (ACE2) which is expressed in various tissue types in the human body. Its infection and systemic condition lead to physical and psychological stress for the patients. During critical illness, and ongoing inflammation, physical and psychological stress both contribute to the patient's outcome. Pre-existing or underlying psychological conditions also affect COVID-19 patients and . lead to poorer prognosis. Stress causes several imbalances including neurohormonal, pro-inflammatory, and metabolic alteration. Ongoing stress and COVID-19 both increase systemic inflammation through interleukin 6 (IL-6), hyperglycemia, and uncontrolled sympathetic drive. These conditions pile up into the vicious cycle of poor prognosis and even mortality. This review article discusses the mechanism of stress to induce inflammation and hyperglycemia that correlated with the poorer outcome in COVID-19 patients. Because of its important role in COVID-19, approaches should be made to overcome stress and homeostatic imbalance caused by stress conditions in COVID-19 patients.
ABSTRACT
Background: There is an urgent need to identify effective therapy to treat coronavirus diseases 2019 (COVID-19). Supplement consumption is becoming popular in this pandemic era. An example of this is probiotic consumption to improve the host's immune system. Objective: This study aimed to prove whether antibodies from people taking probiotics could influence lactate dehydrogenase (LDH), adenosine triphosphate (ATP) values, and cell viability in vitro in peripheral blood mononuclear cells (PBMCs) inoculated with the SARS-CoV-2 spike protein as COVID-19 cells models. Methods: This was an experimental study with control and intervention groups, totally in 12 groups divided based on antibody levels, probiotic intervention, probiotic non-intervention group, SARS-CoV-2 infection group, and non-SARS-CoV-2 infection group. In vitro assays were carried out on PBMC cell cultures inoculated with S1 SARS-CoV-2 recombinant as a COVID-19 cell model. The COVID-19 cell model was given antibodies divided into three antibody level groups: sRBD levels of <3, 325.76 and 646.18. The cytotoxicity assessment examined increased levels of LDH, cytopathic activity by measuring ATP levels, and cell viability by XTT (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) assay. Data were analyzed with SPSS 21 for Windows. Results: This study showed a significant difference in the LDH value (p < 0.001) between each group. The difference in ATP values between groups was significant (p < 0.001). Meanwhile, the cell viability examination found that there was a tendency of decreased XTT (cell viability in %) when there was an increase of LDH and ATP. Conclusion: The change of LDH values occurred most in the antibody group that did not consume probiotics. The highest cytopathic activity based on the ATP values occurred in the infected cell culture group with antibody levels of 325.76 and consuming probiotics. In addition, LDH and ATP activities provided evidence of a significant influence on cell viability.
ABSTRACT
Providing expertise in the care of critically ill patients is one of the main needs of critical care medicine especially in the COVID-19 pandemic era. This goal is particularly challenging given the acknowledged shortage of intensive care specialists. We need the bedside nurse to have real-time access to get continuous reporting monitoring. The intensivist also has access to bed site examination at some time when they are not possible for coming to the intensive care unit (ICU). The big problems during COVID-19 are the limited personal protective equipment the limited number of intensivist doctors and the nature of the disease was very contagious and deadly. It is necessary to find a solution so as not to cause new problems namely the death of medical staff and nurses due to frequent contact with COVID-19 patients. In this article the author wants to open a view to getting solutions to problems in the field by presenting human replacement technology.
ABSTRACT
BACKGROUND: SARS COV-2 is the cause of the current outbreak of COVID-19. The infection of SARS COV-2 causes changes in the gut-lung axis and the intestinal microbiota pro-inflammatory cytokines interaction which leads to the injury of the gastrointestinal tract. One of the symptoms of COVID-19 outside the respiratory system is a complaint in the GIT. MATERIALS AND METHODS: We present a COVID-19 case report that begins with a complaint of abdominal pain. RESULTS: There was no previous suspicion of COVID-19, but after a radiological examination and SARS-COV2 positive PCR result, the patient was proven to be suffering from COVID-19. CONCLUSION: After hospitalization in the ICU for about 14 days, a recovery occurred and the patient was able to go home in a very good clinical condition.